Sebelius: Yes, we’re double-counting Medicare savings

Ed MorrisseyPosted at 2:15 pm on March 4, 2011

Rep. John Shimkus (R-IL) pins down HHS Secretary Kathleen Sebelius on one of the most controversial budget tricks in ObamaCare — the $500 billion cut in Medicare that supposedly goes for both cost control and to fund other parts of the program. Medicare’s own actuary blew the whistle on this sleight of hand in August of last year, which makes this admission by Sebelius a no-brainer:

In her first appearance before the House Energy and Commerce Health Subcommittee since the health-care law passed, Kathleen Sebelius responded to a line of questioning by Republican Rep. John Shimkus of Illinois about whether $500 billion in Medicare cuts were used to sustain the program or pay for the law.

“There is an issue here on the budget because your own actuary has said you can’t double-count,” said Shimkus. “You can’t count — they’re attacking Medicare on the CR when their bill, your law, cut $500 billion from Medicare.”

He continued: “Then you’re also using the same $500 billion to what? Say your funding health care. Your own actuary says you can’t do both. […] What’s the $500 billion in cuts for? Preserving Medicare or funding the health-care law?

Sebelius’ reply? “Both.”

The actuary’s report made this crystal clear last summer:

Bad though all of this is, none of it is actually the worst gimmick in the official report’s advertised improvement in Medicare solvency. That involves the double-counting of Medicare savings. Earlier this year, Congress passed a health care bill containing various new Medicare taxes and constraints on program expenditures. Such savings are assumed in the official report to extend the solvency of Medicare. But Congress chose instead to spend the savings on a new health care entitlement.

The Medicare actuary wrote a memorandum on April 22 of this year calling attention to this “double-counting.” “In practice,” he stated, “the improved Part A financing cannot simultaneously be used to finance other Federal outlays (such as the coverage expansions under the PPACA) and to extend the trust fund, despite the appearance of this result from the respective accounting conventions.”

In other words, money can only be used once. Since the Medicare savings is being spent elsewhere on expanded health care coverage, it is not really being employed to extend Medicare solvency. To claim an improvement in Medicare financing is to mislead about the effects of recent legislation.

Even apart from the double counting, the actuary had little faith in ObamaCare’s ability to deliver the savings claimed by Sebelius in this clip, also noted last summer:

“(T)he financial projections shown in this report for Medicare do not represent a reasonable expectation for actual program operations in either the short range. . . or the long range. . . . I encourage readers to review the ‘illustrative alternative’ projections that are based on more sustainable assumptions for physician and other Medicare price updates.”

These remarkable words are found, in all places, in the “Statement of Actuarial Opinion” in the back of the 2010 annual Medicare Trustees’ Report.

It is difficult to overstate how unusual this development is. The normal process with the annual Trustees’ Reports is for the Trustees to develop and publish the best available projections for the future finances of Social Security and Medicare. The respective Social Security and Medicare actuaries then sign a pro forma blessing of those projections, which is tacked to the back of the report when released to the public.

This year, the Medicare Chief Actuary clearly did not feel he could in good conscience sign such a declaration.

The admission here should prompt the House to demand a new financial accounting of ObamaCare from the CBO in the context of current data, rather than with the rosy scenarios painted by Democrats that ignored both the “doc fix” they later pushed through Congress and the results of this double-counting.